9 February 2018
The Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) – the peak body representing the health workforce in blood borne viruses and sexual health – commends the decision of the Pharmaceutical Benefits Advisory Committee (PBAC) announced today to recommend the listing of HIV Pre Exposure Prophylaxis (PrEP) on the Pharmaceutical Benefits Scheme (PBS) for HIV prevention. PrEP is the regular use of HIV medication by HIV-negative people at high risk of HIV to prevent HIV infection. Clinical trials show that PrEP is highly effective at preventing HIV transmission. ASHM with other leading sector partners has been working to make PrEP available across all Australian jurisdictions, and advocating for prompt and equitable access of this HIV prevention strategy to benefit individuals at-risk of HIV infection.
PBAC’s announcement comes only a few days after PHARMAC in New Zealand (the body that regulates medicines in New Zealand) announced its decision to subsidise Gilead Sciences’ Truvada® – as a daily tablet for PrEP (tenofovir and emtricitabine). In Australia, PrEP drugs Gilead Sciences’ Truvada®, Alphapharm Pty Ltd. (trading as Mylan) Tenofovir Disoproxil Emtricitabine Mylan 300/200), and Generic Health Pty Ltd. Tenofovir EMT GH have been recommended for PBS listing.
“These announcements from PBAC and PHARMAC are a significant win for individuals in Australia and New Zealand – providing equitable availability and affordability of PrEP will now make a very real and significant impact towards eliminating HIV transmissions,” ASHM President, Associate Professor Mark Bloch said.
“PrEP is a highly efficacious strategy available that is available to prevent a person from acquiring HIV. When used daily, it reduces HIV transmission by over 99%. This is a major game-changer in substantively reducing HIV transmissions since the beginning of the epidemic.”
General practitioners, sexual health physicians, hospital specialists and nurses have already played a major role in providing PrEP to those at risk of HIV acquisition through Australia’s current PrEP access studies.
“What Australia has done [through the PrEP studies] is remarkable with over 14,000 people currently on PrEP – approaching almost one half of the estimated number of people in Australia who are eligible for PrEP,” said ASHM Clinical Advisor Associate Professor Edwina Wright – the Chief Investigator of the PrEP X Study – a study that which has provided PrEP to over 4,700 people in Victoria, South Australia and Tasmania.
As the leading education provider of a nationally-accredited HIV prescriber program – ASHM provides best practice guidelines, training and resources that supports HIV clinical practice, including PrEP.
“ASHM is ready to support the health workforce, through our resources and training, to be ready for these PBS recommendations – including GPs, community pharmacists, nurses and community service providers. This will be vital in ensuring that drug initiation, continuity of care for patients starting and continuing PrEP is maintained,” ASHM’s Acting-CEO, Scott McGill said. “ASHM is committed to expanding and furthering the role that all primary care providers have in supporting people both at-risk of HIV and those living with HIV, be at the centre of managing their health and wellness.”
Dr Shane Jackson, National President of the Pharmaceutical Society of Australia (PSA) said, “The PSA is committed to furthering the role that pharmacists have in the successful roll-out of PrEP. Working alongside General Practice, it’s important for pharmacists to be involved and equipped to engage in positive discussions with consumers using PrEP to ensure its effective and quality use is maintained. People using PrEP will have contact with their pharmacist once a month, allowing for detection and management of any adverse events or that other concerns can be managed in a timely manner.”
Shannon Woodward, Nurse Practitioner and President of the Australasian Sexual Health and HIV Nurses Association (ASHHNA) says, “We encourage nurse practitioners in Australia to become involved in prescribing PrEP as a form of HIV prevention, particularly those with experience in sexual health and HIV. We recommend appropriate training and educational coursework for those who would like to include this in their clinical practice.”
ASHM President Associate Professor Bloch who also practices at one of the main access points of EPIC-NSW (Expanded PrEP Implementation in Communities in NSW) – the PrEP trial for high-risk individuals in NSW says, “The listing on the PBS is a major milestone: What this means for Australian clinics like mine is that we, as medical providers, will be able to continue to prescribe and offer this safe and effective prevention measure to our patients when PrEP trials end. GPs will no doubt welcome the PBAC recommendations which will ultimately streamline access of PrEP and will need to be equipped in the PrEP roll-out, and to ensure that appropriate use of medicines is maintained.”
“PrEP offers a great opportunity for people to talk about sex and sexual health with their health care providers. In addition to regular HIV and STI testing and treatments, conversations between clinicians and patients when prescribing PrEP can include STI prevention including condom use, contraception, relationships, and sexual function. PrEP has been shown particularly among gay men to reduce anxiety and allow improved quality sexual relationships,” Dr Chris Bourne, Chair of the Australasian Sexual Health Alliance (ASHA) said.
Access Links to Clinical Resources supporting the HIV workforce
ASHM, through its PrEP guidelines affirms the PBAC position, that individuals should return a negative HIV test result prior to commencing PrEP. Any individual considering PrEP should discuss this with their doctor. Any individual who is on PrEP will need three-monthly monitoring, prevention and adherence support, which will coincide with maintenance prescriptions. The definitions of risk for HIV, guidelines and procedures for the appropriate administration and monitoring of PrEP can be found in the ASHM HIV pre-exposure prophylaxis: clinical guidelines
- ASHM continues to support the workforce to ensure access to PrEP and best practice in guidelines, training and resources – ashm.org.au/HIV/PrEP/
- AFAO and ASHM have produced a PrEP Fact Sheet to assist PrEP users and people with an interest in using PrEP to understand what subsidised access to PrEP through the PBS means. You can view the factsheet here
- AFAO, ASHM and Positive Life NSW produced a PrEP Access Options Fact Sheet in April 2017 including information Personal Importation of PrEP. View it here
Contacts available for further comment:
Associate Professor Edwina Wright (ASHM Clinical Advisor on PrEP) | 0414 242 600 (VIC)
Associate Professor Mark Bloch (ASHM President) | 0423 290 428 (NSW)
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Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) is a peak organisation of health professionals in Australia and New Zealand who work in HIV, viral hepatitis and sexually transmissible infections (STIs). ASHM draws on its experience and expertise to support the health workforce and to contribute to the sector, domestically and internationally. www.ashm.org.au